Efficacy and Tolerability of Levofloxacin versus Clarithromycin based First Line Triple Therapy for Eradication of Helicobacter pylori Infection: A Comparative Study

Background: The increasing prevalence of antibiotic-resistant strains of Helicobacter pylori contributed to reduce the effectiveness of the first-line standard therapy. Consequently, it is necessary to identify alternative regimens that provide better or comparable efficacy and safety. Objective: Compare the efficacy and tolerability of 10days levofloxacin-based triple therapy versus clarithromycin-based triple therapy as a first-line eradication regimen of Helicobacter pylori. Patients and methods: This is an open label observational comparative study. A total of 100 patients with Helicobacter pylori infection were selected; 50 patients were taking 10 day levofloxacin-based triple therapy and the other 50 patients were on 14 day clarithromycin based triple therapy. Eradication rate and adverse effects were evaluated.Results: Helicobacter pylori eradication rates were: levofloxacin group 74%, and clarithromycin group 54%. There were a statistically significant differences in the efficacy between the two regimens (p value < 0.05). In addition, no relevant differences in adverse effects were demonstrated. There were no significant relationship between Helicobacter pylori eradication and gender, age, or smoking.Conclusion: This study showed that levofloxacin-based triple therapy is significantly more effective than clarithromycin-based therapy in the eradication of Helicobacter pylori infection but it does not reach the recommended eradication threshold.Keywords: Antibiotic resistance, Clarithromycin, Eradication rate, Helicobacter pylori, Levofloxacin.